A new platform developed by Cleveland-based Zivian Health aims to help nurse practitioners and physician assistants expand their scope of practice.
The two founders say the HITRUST security and HIPAA compliance platform is designed to help healthcare organizations expand their patient reach and scale their business while streamlining operations. group care.
The compliance conundrum
Those co-founders, Dr. Rafid Fadul, director of pulmonary medicine at Ohio’s Blanchard Valley Health System, and Jesse Corn, chief product officer at Zivian, said the technology is designed with the Codes of practice vary from state to state.
Each state and territory has its own Nursing Practice Act, which oversees licensing throughout a nurse’s career.
If a nurse violates a particular state’s laws or NPA regulations, the state board of nursing can discipline that nurse – which could mean losing their license and any privileges. any multistate licensure they may have, according to an overview of the law in the National Library of Medicine.
While 27 states and Guam grant nurses full authority to practice, the rest reduce or limit their authority to practice, according to NurseJournal’s state-by-state guide.
Many of these states are filled with health care deserts — places where NPs can be valuable in expanding access to much-needed patients, even in the face of physician shortages.
“By 2040, the number of NPs will eclipse the number of physicians,” Fadul said. Healthcare IT news.
But for certified NPs in states that limit their ability to evaluate patient conditions, order tests, diagnose, prescribe medications, and request treatment, they need a licensed physician associate. license and must ensure compliance with all state and federal laws and regulations governing their license, and those of their collaborators.
First, they must find a licensed physician associate appropriate to their practice area, then securely share patient charts. Over the long term, they must monitor all federal and state regulations and permits.
“If you’re in Texas, or if you’re in Georgia, or if you’re in Pennsylvania, it’s different,” Corn explains.
Since launching in August, Zivian has gradually attracted sole practitioners and independent practices. Fadul said the company now has such suppliers in every state, accounting for 45% of its business at this time.
From tired to full of strength
First, the company connects nurses like Kathryn Anderson, APRN, FNP-C, in Cross Roads, Texas, with a physician associate licensed in their state, Fadul said.
Matches are made from Zivian’s list of 4,000 physicians based on services, scope and required licensure, and practice areas.
A board-certified family nurse practitioner with 12 years of experience, Anderson said she was looking for a better work-life balance and so were many of her fellow NPs. So they founded Elite Healthcare, which opened in November 2021, to gain control over patient volume and patient visit times, she said.
They all questioned the “safety” of their licenses when trying to see more than 60 patients with varying levels of acuity every workday under the guidance of local doctors .
“We were just trying and tired,” she said. “Patients are not getting the best possible care.”
Currently, at their independent practice, which has four NPs, patient appointments are scheduled in 30-minute increments.
Although the lakeside community is located in densely populated Denton County, Anderson said traditional medical services are in high demand.
Anderson said she met Fadul when aspiring nurse entrepreneurs left their previous employers and founded Elite. They were looking for a licensed physician associate in Texas, and he responded to the nurses’ only national ad — which Anderson said generated an unexpectedly overwhelming response.
To get more nurse practitioners in states that need physician collaborators, collaboration and compliance platforms are “business opportunities that help [nurses] need,” Anderson said.
She notes that she also has telehealth patients in medically underserved areas outside of Texas, which require compact licensing in those states.
“This model works well anywhere there is a mismatch between supply and demand, especially at the physician level,” Fadul said.
Cut the red tape
Anderson explains that when Elite’s NP team met Fadul, he consulted with other nurse practitioners and they knew immediately that he was the obvious fit for their needs.
However, that was before the Zivian technology was developed – and there was a lot of additional administrative work, she said, including giving Fadul access to the clinic’s electronic health records.
“Instead of requiring physicians to log into multiple electronic health records, Zivian has EHR-free chart reviews in the platform, so collaboration is less burdensome and reduces risk,” Corn said. human error occurs”.
Because it is also secure and file-agnostic, NPs can share images and other patient information.
“It’s SOC 2 supported in the cloud,” Fadul noted.
Anderson said the “seamless uploading of chart information” and secure chat functionality has streamlined the clinic’s communication with Fadul, who remains a licensed associate with the clinic.
Vendors also get the feedback they need from their licensed collaborators faster on the platform, Corn said.
“As we work with more suppliers, it’s important for us to create a transparent, targeted feedback loop for these suppliers and have that in the platform. “
The HIPAA-compliant chat feature allows NPs and PAs to “send notes at any time to their providers,” he said.
“We want to create communication tools or unlock that tool for them in a way that they can feel protected and can talk freely about what they need to talk about, share files, etc.”
Improve access to specialty care
The collaborative team approach is also useful for high-demand specialties such as behavioral health and infertility medicine, Fadul said.
Formerly a labor and delivery nurse, Charisse Fullwood, a psychiatric NP based in Raleigh, now provides maternal and child health care and credits Zivian for making her implementation possible. your practice, Refresh Mind & Body.
She said that access to licensed physician associates in her state has given the green light to the growing number of telemedicine records without having to worry about licensing compliance.
“It was pretty seamless,” Fullwood said.
Fadul noted that because behavioral health is “really suited to virtual first,” collaborative platforms are a great channel to improve access and “really have some impact.”
“Moms are busy,” Fullwood said, so the ability to provide all forms of behavioral telehealth under her associate license is essential.
Includes legal basis
Because Zivian monitors physician licensure and licensure laws across the United States and in all territories, if any red flags appear, it will be reflected on the platform within one month. months, Corn explains.
“They will prescribe,” so nurses need to be assured they are in compliance as soon as their individual agreement is signed.
Doctors are also covered under nurse malpractice insurance.
“One of our main pieces of software is a rules engine where we continuously analyze state regulations and what happens is that gets translated into actions for providers,” he explains. grant”.
“Depending on your state and depending on the type of provider, certain actions will be prompted each month for you to complete and then there will be a quiz where you completed them.”
With state-specific regulations, the platform generates endorsements, then monitors to ensure that contributors stay up to date and complete those tasks.
Additionally, outside counsel assists Zivian in evaluating any proposed rule changes, Fadul noted.
But with artificial intelligence behind them “throwing out new rules and regulations” to maintain their compliance, Anderson said nurses at her clinic no longer have to do “a lot of extra work to keep up” and can focus attention on patient care.
“Having that protection will bring more confidence,” she said.
The company’s certification committee also discusses collaborators “who may not be a good fit for our platform,” Corn noted.
Meet the needs of doctors and businesses
In about six to nine months, Fadul and Corn said, Zivian will roll out additional workforce management services to help healthcare organizations outsource compliance and companies looking to scale expansion.
“It’s the provider for providers, the home for them to manage everything in their career,” including licensing, payer credentialing and more, Corn said.
Such data will also help improve Zivian’s compliance monitoring capabilities, the founders said.
Fadul noted that reducing the learning curve “is also desirable for businesses.”
“Imagine a world where [clinicians] have the ability to upskill and earn what we call ‘micro-badges,’ while also demonstrating the deeper training needed in an area of expertise,” he describes.
Andrea Fox is a senior editor at Healthcare IT News.
Email: [email protected]
Healthcare IT News is a publication of HIMSS Media.
